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Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
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Novel therapeutic agents for the treatment of diabetic kidney disease

Rachel E Hartman1, P S S Rao2, Mariann D Churchwell3

  • 1College of Pharmacy, University of Findlay , Findlay, OH, USA.

Expert Opinion on Investigational Drugs
|August 18, 2020
PubMed
Abstract

Insights

Sodium-glucose-cotransporter-2 (SGLT2) inhibitors show promise in protecting kidneys for diabetic kidney disease (DKD) patients. Novel therapies targeting inflammation and oxidative stress may offer future DKD treatment advancements.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Diabetic kidney disease (DKD) presents complex pathophysiology, elevating risks for cardiorenal events and mortality.
  • Current treatments for DKD primarily involve managing hyperglycemia, hypertension, and inhibiting the renin-angiotensin-aldosterone system.
  • Emerging evidence highlights the nephroprotective potential of antihyperglycemic agents, influencing treatment guidelines for type 2 diabetes patients with chronic kidney disease.

Purpose of the Study:

  • To review current clinical evidence on the nephroprotective effects and side effects of specific antihyperglycemic agents.
  • To explore novel therapeutic targets for DKD, including inflammation, oxidative stress, fibrosis, and vasoconstriction.
  • To provide expert opinion on challenges and future directions in DKD treatment.

Main Methods:

  • Literature search of PubMed and clinicaltrials.gov up to August 2020.
  • Analysis of clinical trial data on sodium-glucose-cotransporter-2 (SGLT2) inhibitors, glucagon-like-peptide-1 (GLP1) agonists, and dipeptidylpeptidase-4 (DPP4) inhibitors.
  • Discussion of emerging therapies and their mechanisms of action in DKD.

Main Results:

  • Sodium-glucose-cotransporter-2 (SGLT2) inhibitors demonstrate significant promise for managing DKD and improving cardiorenal outcomes.
  • Investigational therapies like mineralocorticoid-receptor antagonists and janus kinase inhibitors show potential by targeting key DKD pathways.
  • Early-phase clinical trials indicate benefits from novel therapies targeting inflammation, oxidative stress, and fibrosis.

Conclusions:

  • SGLT2 inhibitors are leading agents for diabetic kidney disease (DKD) treatment, enhancing cardiorenal outcomes.
  • Investigational therapies targeting oxidative stress, inflammation, and nitric oxide synthesis are promising for DKD.
  • Future DKD therapies may involve novel targets and biomarkers for early detection and slowed progression.
Keywords:
Renal diseasealbuminuriadiabetic kidney diseaseglomerular filtration rateinvestigational agentsnovel drugs

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